Impairment of Quality of Life and Mental Health Status in Adult-Onset Atopic Dermatitis

BACKGROUND: Patients with atopic dermatitis (AD) have an impaired quality of life (QoL). To our knowledge, impairments in mental health status and health-related QoL (HRQoL) have not yet been evaluated in adult-onset and child-onset AD in a large-scale study. OBJECTIVE: This study compared the mental health status and HRQoL (using the EuroQoL [EQ] five-dimensional [5D] questionnaire) in child-onset AD and adult-onset AD to those in normal controls. METHODS: We used nationwide, population-based, cross-sectional data from the Korean National Health and Nutrition Examination Survey conducted from 2008 to 2013. We performed multiple logistic regression analyses with adjustments for age, sex, body mass index, income, education level, drinking status, current smoking, regular exercise, diabetes mellitus, hypertension, and dyslipidemia, and analyzed odds ratios (OR) for factors associated with impaired QoL. RESULTS: The OR for strong psychological stress, depressed mood, and suicidal ideation were significantly increased in adult-onset AD patients compared to in normal controls. In addition, the OR (95% confidence interval [CI]) values for the EQ-5D questionnaire responses (for physical activity, self-control, daily activities, pain/discomfort, and anxiety/depression) were significantly high in adult-onset AD compared to in normal controls after adjustments for covariates. However, patients with child-onset AD showed a significantly increased OR (95% CI) only for problems in pain/discomfort in the EQ-5D questionnaire. CONCLUSION: Adult-onset AD patients suffer from impaired HRQoL and significant mental problems compared to normal controls. Dermatologists should focus not only on the clinical phenotype but also patients’ psychological health status to ensure a better treatment outcome.